mental health

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mental health
2010-07-10 18:54:01
physical problems psychological sources

ch 22
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  1. role of emotions in health
    • health is conseridered as a whole
    • fight or flight response
  2. anxiety & stress
    • physicalogical stress response or biochemical fight or flight
    • general adaption syndrome- how the body response to stressors

    when person under stress, tension, or anxiety the body starts biochemicals, the body's command post the hypothalumus commnicates w/ pituitary gland which then notifies adrenal gland & releases hormones like dopamine, epinephrine, norepinepherine, & cortisol, body response to even sm. changes
  3. childhood sources
    S/S of stress colics, atopic dermititis, allergic reactions, GI problems, asthma, aches, pain

    kids that have support from parents deal better w/ stress
  4. common psychophysical problems
    • the GI is the system that encounters most problems
    • GI- indigestion, vomiting, constipation, diarrhea, ulcers,
    • Resp.- asthma,
    • Cardiac- increase in B/P,
    • SEE PG 239
  5. psycholphysical theories
    stress response theory- ppl are biochemically patterned to react to stress, the ANS prepares fight or flight, usually results to physical distrubance w/i body

    carl jungs theory- believes stress leads to illness ( like GI problems or B/P)

    Erich Fromm theory- certain personility prone to cretain illness from stress

    Organic weakness theory- every person has body system that is more sensitive then other system

    always believe pt compliants
  6. somatoform disorders
    • feeling the physical symptoms in absence of disease
    • defined as a person's symptoms suggest the presence of medical illness

    Dx- excluding physical dysfunctions, presenceof drugs, or mental health problems, if no of these found itz concidered somatoform disorders

    S/S- of illness may b pt way od coping w/ emotional distress

    emotional distress depletes the body's energy leading to decrease immune function which make them at higher risk 4 illness
  7. cultural influences
    • somatic illnesses based on cultural & spiritual beleifs
    • assessments & TX shouldn't threaten or challenge beliefs
    • health care providers need to learn & respect all cultural beliefs effective interventions
  8. Critiria 4 DX
    • 1. no organic medial condition that explans the symptoms can b found
    • 2. the disorder significantly disrupts or impairs ones level of functioning
    • 3. pt is unaware of or is unable to expres their emotional distress

    ppl have factitious disorders- they intentionally produce S/S of illness or disability so ppl could beleive them
  9. somatization disorders
    • polysymptomatic disorders- many differant conditions
    • genetic & enviromental factors contribute to risk of getting somatization disorder
    • look 4 tx w/ many DR so they get different meds making it likely to have drug interactions
    • complaints are usually exaggerated
    • signs of depression & anxety all very likely
  10. differance between somatization disorder & medical problems
    • many organ systems involved in somatization disoreder
    • characterized by early onset & chronic condition w/ no changes over time
    • absence of labs
  11. conversion disorders
    • considered somatoform disorder where pt present problems RT sensory or motor functions
    • more common in ppl w/ lower socioeconomic status, living in rural areas, ppl w/ low health care knowledge
    • when assessed for this their social & cultural backgrounds are concidered
    • in kids they get a gait problem, adults get sensory & motor disturbances
    • symptoms appear slowly & increase w/ time & last a short time
    • thought to b a emotional (psyphic) conflict

    Tx- eliminating causes/stressors, referring to therapiest where RX antidepressants & antianxiety are given, & behavioral tech given

    La Belle indifferance- lack of concerns about S/S
  12. criteria 4 DX conversion disorder
    • 1.Atleast 1 symptom involves sensory or motor system & suggest nuerological problem
    • 2.S/S brought on or worsened by stressors
    • 3.S/S are not intentionally produced
    • 4.S/S cause distress & impair ADL
    • 5.after exam S/S cant be explained
  13. hypochondriasis
    • thinking that they are always sick even when labs results come back clear (DANA), are usually dr. shoppers
    • anxiety, depression, & commpulsive personality traits are present w/ hypochondiacs

    patience, therapeutic communication skills, & alert observations are needed when caring for this pt
  14. criteria 4 DX hypochondiasis
    • 1. fear of having illness
    • 2. pt not delusional they admit that they have an unreasonable concern
    • 3. still think they are sick even after labs shows no disease
    • 4. pt under major stress or impaired ADL
    • 5. has been present 4 @least 6 mon.
  15. other somatoform disorders
    somatoform pain disorder- when pain or discomfort is the focus of distress & no other cause identified. pt benefit from seeing pain clinic

    • body dysmorphic disorder- most common site is head & face or ear, nose, thinning hair, droopin chin, crooked teeth, & other imperfections
    • they concider themselves as ugly/unacceptable, can lead to suicide
  16. facticious disorders & mallingering
    they differ from somatoform disorders in that S/S are intentionally produced

    • facticious disorders
    • they produce S/S of illness for some kind of gain
    • factisious disorder by proxy aka munchausen syndrome- producing S/S to others mostly done to kids
    • hard to DX b/c caregiver changes DR. when they feel they are gonna be caught

    • mallingering- produce symptoms to meet recognizable goal (to not go to school) sounds like MEEEEE DANA, or to get some
    • type of compensation like food shelter
  17. implications 4 care providers
    • rule out presence of any physical disease or dysfunction
    • develope trust
    • encourage expression of feelings & emotional stress rathr then physical complaints
    • meet physical needs when necessary, but encourage independance